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Home My WebLink AboutPermit Electrical 2007-7-27 ZON INITIALS DATE SOURCE LDZ- iJiv1 ,-;n-C, (YlfFifL:> 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (54])726-3689 ELECTRICAL PERMIT APPLICATION City Job Number CD-Yv1 Z-C5Dl- 0 ] , /2- 1.. LOCATION OF INSTALLATION: ~256 ~alJ1~~//a ,<;/-. LEGAL DESCRIPTION: i,tJ)... :S~ 3~ {)060 U JOB DESCRIPTION: :;J /'m?~('_1- Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. CONTRACTOR 'INSTALLATION ONLY Electrical Contractor G ~ 5 V\~ I \ nc Address FD ~ \LtCOz. City Spfld Phone lY l-12:~ Supervisor License Number !-\<(j1yS , OIJ1()1- . ~COLA q; I /00 Expiration Date Constr. Contr. Number Expiration Date Signature of Supervising Electrician ~F~ A1J,,/7ad (;j,J /-b-J Address 'I2.5{) (.t) (y)"'///O <;1-- . City A,....: lf~re~fflW r~1is-y~ 7 tic ' culupted by the OreNon 1 ;';':"ty 1.)" bon Cent Tn l;) ,,'u1! OWN:dR~l($lT~ OS9 rules are set forth :I Vi . . ~lOthroughOAR 952~O!t1- The ins a.. orf~ matmiD~~ ~fltA~'tur~~ is not i1fiJfhle~ !WI~~Wt).ofMote: the telephone Y r 'Or the Oregon Utmty Notfflcatlon Owners Signatu~nter is 1-800.332-2344). i Owners Name Inspection Request: 726-3769 7 /dl lOr Date 3. COMPLETE FEE SCHEDULE BELOlV A. New Residential- Single or Multi-Family per dwelling unit. Service Included 1000 sq, ft, or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50.00 B. Services or Feeders - Installation, Alterations or Relocation: 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsN olts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 ......""\ $ ~04," , rJ U C. Temporary Services or Feeders Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above, D. Branch Circuits New Alteration or Extension Per Panei One Circuit Each Additional Circuit or with Service or Feeder Permit $ 50.00 $ 69.00 $100.00 $ 43.00 $ 3.00 E. Miscellaneous (Service/feeder not included) -Each Installation Pump qrJrrigation $ 50,00 , ,;..J, r\) ..~.. l'l Sign/OtttliriGLifJhtini $ 50~0 Limit'~d Jfrl~?~ Hle~~~hk EXPIRE If nlE~~:"Q.~ Limite~i,i1&'-;"t~NQE~<uTHiS PERMIT I 4!q;) . II/IIV ~-N E1J fs A Minimum .~fe~kff~A~~fBtf.~~ Surcharges. 4. SUBTOTAL OF ABOVE S5 .00 8% State Surcharge Lf. '-" 0 10% Administrative Fee <5 D 5% Technology Fee ::J, ,e:;' TOTAL Shared Drive(T:)/Building FonTIs/Electrical Permit APPli~Ci]~.~ Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01112 ISSUED: 07/27/2007 APPLIED: 07/27/2007 EXPIRES: 01/27/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4250 CAMELLIA ST ASSESSOR'S PARCEL NO.: 1702323300800 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Alteration Residential PROJECT DESCRIPTION: Service Reconnect Owner: RACHAEL CHILTON Address: 4250 CAMELLIA ST SPRINGFIELD OR 974778 Phone Number: 541-335-9927 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor C & SELECTRIC License 3849 BUILDING INFORMATION I Expiration Date 09/01/2008 Phone 541-741-2236 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMA nON I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street ImprovAnmMTION: Oregon law requIres you to Storm Sewen.!e"qtl~l.es adopted by the Oregon Utility , 'l'qO~iUcalr6n Center. Those rules are set forth Special Inst'YFB<<Jm 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules ry Notes: calling the center, (Note: the telp.rr. (i , .., number for thE=! (')rpfl(Y, 11.;1;'" '- I '" ", , Center is 1-':~.'(---' ,. ;: '" Uv \...''-4 _"- , ./. Valuation Descri Sidewalk Type: Downspouts/Drains: NOTICE: , THIS PERMIT S AU~HORIZED U~~'-t ~~~lR_E IF THE Wnov ro, ,lvlclVl,;ED OR -'. "V rtHMIT IS .. t~N 180 DAY PER:gtBANDONED FOR NOT Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pal.!:e 1 of2 Status Iss u ed CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2007-01112 ISSUED: 07/27/2007 APPLIED: 07/27/2007 EXPIRES: 01/27/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project LFees Paid I Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Service Reconnect Amount Paid Date Paid Receipt Number $5.50 7/27/07 2200700000000001195 $2.75 7/27/07 2200700000000001195 $4.40 7/27/07 2200700000000001195 $55.00 7/27/07 2200700000000001195 Total Amount Paid $67.65 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. I Reouired Insoections I Electric Service: Approval required prior to utility company energizing service. By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. Owner or Contractors Signature Date Pal.!:e 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2007-01112 COM2007-01112 COM2007-01112 COM2007-01112 Payments: Type of Payment Check cReceint 1 RECEIPT #: Description Service Reconnect + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By RACHAEL CHILTON City of Springfield Official Receipt Development Services Department Public Works Department 2200700000000001195 Date: 07/27/2007 Item Total: Check Number Authorization Received By Batch Number Number How Received ddk 163 In Person Payment Total: Page 1 of I 10:21:25AM Amount Due 55.00 2.75 4.40 5.50 $67.65 Amount Paid $67.65 $67.65 7/27/2007